Search results for: vulval skin condition
1485 Muslim Husbands’ Participation in Women’s Health and Illness: A Descriptive Exploratory Study Applied to Muslim Women in Indonesia
Authors: Restuning Widiasih, Katherine Nelson, Joan Skinner
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Muslim husbands have significant roles in the family including their roles in women’s health and illness. However, studies that explore Muslim husbands’ participation in women’s health is limited. The objective of this study was to uncover Muslim husbands’ participation in women’ health and illness including cancer prevention and screening. A descriptive exploratory approach was used involving 20 Muslim women from urban and rural areas of West Java Province, Indonesia. Muslim women shared experience related to their husbands support and activities in women’s health and illness. The data from the interviews were analyzed using the Comparative Analysis for Interview (CAI). Women perceived that husbands fully supported their health by providing opportunities for activities, and reminding them about healthy food, their workloads, and family planning. Husbands actively involved when women faced health issues including sharing knowledge and experience, discussing any health problems, advising for medical check-ups, and accompanying them for treatments. The analysis also found that husbands were less active and offered less advice regarding prevention and early detection of cancer. This study highlights the significant involvement of Muslim husbands in women’s health and illness, yet a lack of support from husbands related to screening and cancer prevention. This condition could be a burden for Muslim women to participate in health programs related to cancer prevention and early detection. Health education programs to improve Muslim husbands’ understanding of women’s health is needed.Keywords: descriptive exploratory study, Muslim husbands, Muslim women, women's health and illness
Procedia PDF Downloads 5131484 Review of Existing Pumped Storage Technologies and their Application in the Case of Bistrica Pump Storage Plant
Authors: Dušan Bojović, Wei Huang, Zdravko Stojanović, Jovan Ilić
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In an era of ever-growing electricity generation from renewable energy sources, namely wind and solar, a need for reliable energy storage and intensive balancing of the electric power system gains significance. For decades, pump storage hydroelectric power plants have proven to be an important asset regarding the storage of generated electricity. However, with the increasing overall share of wind and solar in electric systems at large, the importance of electric grid stability keeps growing. A large pump storage project, the Bistrica Pump Storage Plant (PSP), is currently under development in Serbia. The Bistrica PSP will be designed as a 600+ MW power plant, which is envisaged as a significant contributor to the Serbian power grid stability as more and more renewable energy sources are implemented over time. PSP Bistrica is seen as a strategically important project on the green agenda path of the Electric Power Industry of Serbia as a necessary pre-condition for the safe implementation of other renewable energy sources. The importance of such a plant would also play an important role in reducing the electricity production from coal, i.e., thermoelectric power plants. During the project’s development, various techniques and technologies are evaluated for the purpose of determining the optimum (the most profitable) solution. Over the course of this paper, these technologies – such as frequency-regulated pump turbines and ternary sets will be presented, with a detailed explanation of their possible application within the Bistrica PSP project and their relative advantages/disadvantages in this particular case.Keywords: hydraulic turbines, pumped storage, renewable energy, competing technologies
Procedia PDF Downloads 921483 Jelly and Beans: Appropriate Use of Ultrasound in Acute Kidney Injury
Authors: Raja Ezman Raja Shariff
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Acute kidney injury (AKI) is commonly seen in inpatients, and places a great cost on the NHS and patients. Timely and appropriate management is both nephron sparing and potentially life-saving. Ultrasound scanning (USS) is a well-recognised method for stratifying patients. Subsequently, the NICE AKI guidance has defined groups in whom scanning is recommended within 6 hours of request (pyonephrosis), within 24 hours (obstruction/cause unknown), and in whom routine scanning isn't recommended (cause for AKI identified). The audit looks into whether Stockport NHS Trust USS practice was in line with such recommendations. The audit evaluated 92 patients with AKI who had USS, between 01/01/14 to 30/04/14. Data collection was divided into 2 parts. Firstly, radiology request cards and the online imaging software (PACS) were evaluated. Then, the electronic case notes (ADVANTIS) was evaluated further. Based on request cards, 10% of requests were for pyonephrosis. Only 33% were scanned within 6hours and a further 33% within 24hours. 75% were requested for possible obstructions and unknown cause collectively. Of those due to possible obstruction, 71% of patients were scanned within 24 hours. Of those with unknown cause, 50% were scanned within 24 hours. 15% of requests had a cause declared and so potentially did not require scanning. Evaluation of the patients’ notes suggested further interesting findings. Firstly, potentially 39% of patients had a known cause for AKI, therefore, did not need USS. Subsequently, the cohort of unknown cause and possible obstruction was collectively reduced to 45%. Alarmingly the patient cohort with possible pyonephrosis went up to 16%, suggesting an under-recognition of this life-threatening condition. We plan to highlight these findings within our institution and make changes to encourage more appropriate requesting and timely scanning. Time will tell if we manage to save or increase our costs in this cost-conscious NHS. Patient benefits, though, seem to be guaranteed.Keywords: AKI, ARF, kidney, renal
Procedia PDF Downloads 4001482 Environmental Effect on Corrosion Fatigue Behaviors of Steam Generator Forging in Simulated Pressurized Water Reactor Environment
Authors: Yakui Bai, Chen Sun, Ke Wang
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An experimental investigation of environmental effect on fatigue behavior in SA508 Gr.3 Cl.2 Steam Generator Forging CAP1400 nuclear power plant has been carried out. In order to simulate actual loading condition, a range of strain amplitude was applied in different low cycle fatigue (LCF) tests. The current American Society of Mechanical Engineers (ASME) design fatigue code does not take full account of the interactions of environmental, loading, and material's factors. A range of strain amplitude was applied in different low cycle fatigue (LCF) tests at a strain rate of 0.01%s⁻¹. A design fatigue model was constructed by taking environmentally assisted fatigue effects into account, and the corresponding design curves were given for the convenience of engineering applications. The corrosion fatigue experiment was performed in a strain control mode in 320℃ borated and lithiated water environment to evaluate the effects of a mixed environment on fatigue life. Stress corrosion cracking (SCC) in steam generator large forging in primary water of pressurized water reactor was also observed. In addition, it is found that the CF life of SA508 Gr.3 Cl.2 decreases with increasing temperature in the water environment. The relationship between the reciprocal of temperature and the logarithm of fatigue life was found to be linear. Through experiments and subsequent analysis, the mechanisms of reduced low cycle fatigue life have been investigated for steam generator forging.Keywords: failure behavior, low alloy steel, steam generator forging, stress corrosion cracking
Procedia PDF Downloads 1251481 Optimization of Extraction Conditions and Characteristics of Scale collagen From Sardine: Sardina pilchardus
Authors: F. Bellali, M. Kharroubi, M. Loutfi, N.Bourhim
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In Morocco, fish processing industry is an important source income for a large amount of byproducts including skins, bones, heads, guts and scales. Those underutilized resources particularly scales contain a large amount of proteins and calcium. Scales from Sardina plichardus resulting from the transformation operation have the potential to be used as raw material for the collagen production. Taking into account this strong expectation of the regional fish industry, scales sardine upgrading is well justified. In addition, political and societal demands for sustainability and environment-friendly industrial production systems, coupled with the depletion of fish resources, drive this trend forward. Therefore, fish scale used as a potential source to isolate collagen has a wide large of applications in food, cosmetic and bio medical industry. The main aim of this study is to isolate and characterize the acid solubilize collagen from sardine fish scale, Sardina pilchardus. Experimental design methodology was adopted in collagen processing for extracting optimization. The first stage of this work is to investigate the optimization conditions of the sardine scale deproteinization on using response surface methodology (RSM). The second part focus on the demineralization with HCl solution or EDTA. Moreover, the last one is to establish the optimum condition for the isolation of collagen from fish scale by solvent extraction. The basic principle of RSM is to determinate model equations that describe interrelations between the independent variables and the dependent variables.Keywords: Sardina pilchardus, scales, valorization, collagen extraction, response surface methodology
Procedia PDF Downloads 4171480 Effect of Online Mindfulness Training to Tertiary Students’ Mental Health: An Experimental Research
Authors: Abigaile Rose Mary R. Capay, Janne Ly Castillon-Gilpo, Sheila A. Javier
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The transition to online learning has been a challenging feat on the mental health of tertiary students. This study investigated whether learning mindfulness strategies online would help in improving students’ imagination, conscientiousness, extraversion, agreeableness and emotional stability, as measured by the International Personality Item Pool (IPIP) Big Five Factor Markers, as well as their dispositional mindfulness as measured by the Mindfulness Attention Awareness Scale (MAAS). Fifty-two college students participated in the experiment. The 23 participants assigned to the treatment condition received 6-weekly experiential sessions of online mindfulness training and were advised to follow a daily mindfulness practice, while the 29 participants from the control group only received a 1-hour lecture. Scores were collected at pretest and posttest. Findings show that there was a significant difference in the pretest and posttest scores of students assigned in the treatment group, likewise medium effect sizes in the variables: dispositional mindfulness (t (22) = 2.64, p = 0.015, d = .550), extraversion (t (22) = 2.76, p = 0.011, d = 0.575), emotional stability (t (22) = 2.99, p = 0.007, d = .624), conscientiousness (t (22) = 2.74, p = 0.012, d = .572) and imagination (t (22) = 4.08, p < .001), but not for agreeableness (t (22) = 2.01, p = 0.057, d = .419). No significant differences were observed on the scores of the control group. Educational institutions are recommended to consider teaching basic mindfulness strategies to tertiary students, as a valuable resource in improving their mental health as they navigate through adjustments in online learning.Keywords: mindfulness, school-based interventions, MAAS, IPIP Big Five Markers, experiment
Procedia PDF Downloads 581479 Quantum Engine Proposal using Two-level Atom Like Manipulation and Relativistic Motoring Control
Authors: Montree Bunruangses, Sonath Bhattacharyya, Somchat Sonasang, Preecha Yupapin
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A two-level system is manipulated by a microstrip add-drop circuit configured as an atom like system for wave-particle behavior investigation when its traveling speed along the circuit perimeter is the speed of light. The entangled pair formed by the upper and lower sideband peaks is bound by the angular displacement, which is given by 0≤θ≤π/2. The control signals associated with 3-peak signal frequencies are applied by the external inputs via the microstrip add-drop multiplexer ports, where they are time functions without the space term involved. When a system satisfies the speed of light conditions, the mass term has been changed to energy based on the relativistic limit described by the Lorentz factor and Einstein equation. The different applied frequencies can be utilized to form the 3-phase torques that can be applied for quantum engines. The experiment will use the two-level system circuit and be conducted in the laboratory. The 3-phase torques will be recorded and investigated for quantum engine driving purpose. The obtained results will be compared to the simulation. The optimum amplification of torque can be obtained by the resonant successive filtering operation. Torque will be vanished when the system is balanced at the stopped position, where |Time|=0, which is required to be a system stability condition. It will be discussed for future applications. A larger device may be tested in the future for realistic use. A synchronous and asynchronous driven motor is also discussed for the warp drive use.Keywords: quantum engine, relativistic motor, 3-phase torque, atomic engine
Procedia PDF Downloads 631478 The Reason Why Al-Kashi’s Understanding of Islamic Arches Was Wrong
Authors: Amin Moradi, Maryam Moeini
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It is a widely held view that Ghiyath al-Din Jamshid-e-Kashani, also known as al-Kashi (1380-1429 CE), was the first who played a significant role in the interaction between mathematicians and architects by introducing theoretical knowledge in Islamic architecture. In academic discourses, geometric rules extracted from his splendid volume titled as Key of Arithmetic has uncritically believed by historians of architecture to contemplate the whole process of arch design all throughout the Islamic buildings. His theories tried to solve the fundamental problem of structural design and to understand what makes an Islamic structure safe or unsafe. As a result, al-Kashi arrived at the conclusion that a safe state of equilibrium is achieved through a specific geometry as a rule. This paper reassesses the stability of al-Kashi's systematized principal forms to evaluate the logic of his hypothesis with a special focus on large spans. Besides the empirical experiences of the author in masonry constructions, the finite element approach was proposed considering the current standards in order to get a better understanding of the validity of geometric rules proposed by al-Kashi for the equilibrium conditions of Islamic masonry arches and vaults. The state of damage of his reference arches under loading condition confirms beyond any doubt that his conclusion of the geometrical configuration measured through his treaties present some serious operational limits and do not go further than some individualized mathematical hypothesis. Therefore, the nature of his mathematical studies regarding Islamic arches is in complete contradiction with the practical knowledge of construction methodology.Keywords: Jamshid al-Kashani, Islamic architecture, Islamic geometry, construction equilibrium, collapse mechanism
Procedia PDF Downloads 1321477 The Factors That Influence the Self-Sufficiency and the Self-Efficacy Levels among Oncology Patients
Authors: Esra Danaci, Tugba Kavalali Erdogan, Sevil Masat, Selin Keskin Kiziltepe, Tugba Cinarli, Zeliha Koc
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This study was conducted in a descriptive and cross-sectional manner to determine that factors that influence the self-efficacy and self-sufficiency levels among oncology patients. The research was conducted between January 24, 2017 and September 24, 2017 in the oncology and hematology departments of a university hospital in Turkey with 179 voluntary inpatients. The data were collected through the Self-Sufficiency/Self-Efficacy Scale and a 29-question survey, which was prepared in order to determine the sociodemographic and clinical properties of the patients. The Self-Sufficiency/Self-Efficacy Scale is a Likert-type scale with 23 articles. The scale scores range between 23 and 115. A high final score indicates a good self-sufficiency/self-efficacy perception for the individual. The data were analyzed using percentage analysis, one-way ANOVA, Mann Whitney U-test, Kruskal Wallis test and Tukey test. The demographic data of the subjects were as follows: 57.5% were male and 42.5% were female, 82.7% were married, 46.4% were primary school graduate, 36.3% were housewives, 19% were employed, 93.3% had social security, 52.5% had matching expenses and incomes, 49.2% lived in the center of the city. The mean age was 57.1±14.6. It was determined that 22.3% of the patients had lung cancer, 19.6% had leukemia, and 43.6% had a good overall condition. The mean self-sufficiency/self-efficacy score was 83,00 (41-115). It was determined that the patients' self-sufficiency/self-efficacy scores were influenced by some of their socio-demographic and clinical properties. This study has found that the patients had high self-sufficiency/self-efficacy scores. It is recommended that the nursing care plans should be developed to improve their self-sufficiency/self-efficacy levels in the light of the patients' sociodemographic and clinical properties.Keywords: oncology, patient, self-efficacy, self-sufficiency
Procedia PDF Downloads 1701476 Interaction of Dietary Protein and Vitamin E Supplementation on Gastrointestinal Nematode (Gnt) Parasitism of Naturally Infected Lambs
Authors: Ayobami Adeyemo, Michael Chimonyo, Munyaradzi Marufu
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Gastrointestinal nematode (GNT) infection significantly hinder sustainable and profitable sheep production on rangelands. While vitamin E and protein supplementation have individually proven to improve host immunity to parasitism in lambs, to our knowledge, there is no information on the interaction of dietary vitamin E and protein supplementation on lamb growth and GIN faecal egg counts in naturally infected lambs. Therefore, the current study investigated the interaction of dietary protein and vitamin E supplementation on faecal egg counts (FEC) and growth performance of lambs. Twenty four Dohne Merino lambs aged 12 months were allocated equally to each of four treatment combinations, with six lambs in each treatment group for a period of eight weeks. Treatment one lambs received dietary protein and vitamin E (PE), treatment two lambs received dietary protein and no vitamin E (PNE), treatment three received dietary vitamin E and no protein (NPE), and treatment four received no dietary protein and vitamin E supplementation (NPNE). The lambs were allowed to graze on Pennisetum clandestinum contaminated with a heavy load of nematodes. Dietary protein supplementation increased (P < 0.01) average daily gain (ADG) and body condition scores (BCS). Dietary vitamin E supplementation had no effect (P > 0.05) on ADG and BCS. There was no interaction (P > 0.05) between dietary protein and vitamin E supplementation on ADG and BCS. Combined supplementation of dietary protein and vitamin E supplementation significantly reduced (P < 0.01) faecal egg counts and larval counts, respectively. Also, dietary protein and vitamin E supplementation reduced GNT faecal egg counts over the exposure period. The current findings support the hypothesis that the interaction of dietary protein and vitamin E supplementation reduced faecal egg counts and larval counts in lambs. This necessitates future findings on the interaction of dietary protein and vitamin E supplementation on blood associated profiles.Keywords: gastrointestinal nematodes, nematode eggs, Haemonchus, Trichostrongylus
Procedia PDF Downloads 2101475 Effect of Many Levels of Undegradable Protein on Performance, Blood Parameters, Colostrum Composition and Lamb Birth Weight in Pregnant Ewes
Authors: Maria Magdy Danial Riad
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The objective of this study was to investigate the effect of different protein sources with different degradability ratios during late gestation of ewes on colostrum composition and its IgG concentration, body weight change of dams, and birth weight of their lambs. Objectives: 35 multiparous native crossbred ewes (BW= 59±2.5kg) were randomly allocated to five dietary treatments (7 ewes / treatment) for 2 months prior to lambing. Methods: Experimental diets were isonitrogenous (12.27% CP) and isocaloric (2.22 Mcal ME/kg DM). In diet I (the control), solvent extract soybeans (SESM 33% RUP of CP), II feed grade urea (FGU 31% RUP), III slow release urea (SRU 31% RUP). As sources of undegradable protein, extruded expeller SBM-EESM 40 (37% RUP) and extruded expeller SBM-EESM 60 (41% RUP) were used in groups IV and V, respectively. Results showed no significant effect on feed intake, crude protein (CP), metabolizable energy (ME), and body condition score (BCS). Ewes fed the 37% RUP diet gained more (p<0.05) weight compared with ewes fed the 31% RUP diet (5.62 vs. 2.5kg). Ewes in EESM 60 had the highest levels of fat, protein, total solid, solid not fat, and immunoglobulin and the lowest in urea N content (P< 0.05) in colostrum during the first 24hrs after lambing. Conclusions: Protein source and RUP levels in ewes’ diets had no significant effect (P< 0.05) on lambs’ birth weight and ewes' blood biochemical parameters. Increasing the RUP content of diet during late gestation resulted in an increase in colostrum constituents and its IgG level but had no effect on ewes’ performance and their lambs’ outcome.Keywords: colostrum, ewes, lambs output, pregnancy, undegradable protein
Procedia PDF Downloads 501474 In silico and in vitro Investigation of the Role of Acinetobacter baumannii in the Pathogenesis of Multiple Sclerosis
Authors: Kieren Luellman, Makenzi Rockwell, Eduardo Callegari, Nichole Haag, Chun Wu
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Multiple sclerosis (MS) is an autoimmune disorder that damages the myelin sheath of neurons in the central nervous system. The presence of Acinetobacter bacteria and anti-Acinetobacter antibodies in MS patients has led to the hypothesis that the bacteria may contribute to MS pathogenesis. In this study, the protein sequences of Acinetobacter baumannii were compared to five peptides from three mammalian myelin proteins, i.e., Proteolipid Protein (PLP): PLP 139-151, PLP 178-191, Myelin Basic Protein (MBP): MBP 84-104 and Myelin Oligodendrocyte Glycoprotein (MOG): MOG 35-55 and MOG 92-106 respectively, known to induce experimental autoimmune encephalomyelitis (EAE), a condition similar to MS. We found 11 hits (i.e., with five or more amino acid sequence similarity) in Acinetobacter baumannii, which are identical or similar to PLP139-151, 32 hits to PLP178-191, 35 to MBP 84-104, 41 hits to MOG 35-55 and 26 hits to MOG92-106. In addition, Western blotting was used to assess possible interaction between the bacterial proteins and human anti-MBP, anti-MOG, and anti-PLP antibodies produced in rabbits, corresponding to MBP 84-104, MOG 35-55, and PLP 139-151, respectively. We found that both human Polyclonal anti-MOG antibody and anti-PLP antibody recognized a protein or more proteins of the same molecular mass of around 25 kDa. in Acinetobacter baumannii. The results suggested that this/these protein(s) might potentially serve as antigen(s) to induce anti-MOG antibody and anti-PLP antibody production in mammalian B cells. The proteomic study identified 433 hits, among which the sequence of Acinetobacter baumannii protein 491 subunit A matches a previously published enzyme Acinetobacter 3-Oxoadipate CoA-Transferase, in which a fragment of its peptide was observed to recognize MS patient serum via ELISA method. Our findings might pave the road to understanding one of the pathogenesis mechanisms of MS.Keywords: multiple sclerosis, pathogenesis, Acinetobacter baumannii, antibody recognition
Procedia PDF Downloads 1211473 Poverty and Environmental Degeneration in Central City of Ibadan, Nigeria
Authors: Funmilayo Lanrewaju Amao, Amos Olusegun Amao, Odetoye Adeola Sunday, Joseph Joshua Olu
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There is a high magnitude of housing inadequacy in urban centers in Nigeria. This is manifested in quantitative and qualitative terms. Severe overcrowding and insanitary physical environment characterize the housing in the urban centers. The culminating effect of this is the growth of slum areas. This paper takes a critical look at inter-allia history and anatomy, general characteristic, present condition, root causes, official responses and reactions, possible solution and advocacy housing in central city slum of Ibadan. It also examines slum development and consequent deviant behaviors in the inner-city neighborhoods of Ibadan, the capital city of Oyo State, Nigeria. Residing there are many underemployed and unemployed individuals, these are miscreants who are generally socially frustrated. The activities of this group of people are a cause of concern. Deleterious and anti-social behaviors such as prostitution and house burglary are commonplace in the neighborhoods. The paper examines building conditions in the neighborhoods and the nexus with the deviant behavior of the inhabitants. The paper affirms that there is monumental deficiency in housing quality, while the design and the arrangement of the buildings into spatial units significantly influence the behavior of the residents. The paper suggests a two-prong approach in dealing with the situation. This involves urban renewal and slum upgrading programmes on the one hand, and an improvement in the socio-economic circumstances of the inhabitants, especially an increase in employment opportunity on the other.Keywords: slum, behavior, housing, poverty, environmental degeneration
Procedia PDF Downloads 4041472 Green Concrete for Sustainable Indonesia Structures: Lightweight Concrete Using Oil Palm Shell as Coarse Aggregate with Superplasticizer and Fly Ash
Authors: Feny Acelia Silaban
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The development of Indonesia’s infrastructure in many islands is significantly increased through the years. Based on this condition, concrete materials which are extracted from natural resources are over exploited and slowly becoming rare, thus the demand for alternative materials becomes so urgently crucial. Oil Palm is one of the biggest commodities in Indonesia with the total amount of 31 million tons in the last 2014. The production of palm oil also generates lots of solid wastes in the form of Oil Palm Shell (OPS). Constructing more environmentally sustainable structures can be achieved by producing lightweight concrete using the Oil Palm Shell (OPS). This paper investigated the effects of OPS and combination of Superplasticizer and fly ash proportion of lightweight concrete mix design to the compressive strength, flexure strength, modulus of elasticity, shrinkage behavior, and water absorption. The Oil Palm Shell had undergone special treatment by washing it with hot water and soap to reduce the oil content. This experiment used four different proportions of Superplasticizer with fly ash and 30 % OPS proportion from the weight of total compositions mixture by the result of trial mix. The experiment result showed that using OPS coarse aggregates and Superplasticizer with fly ash, the average of 28-day compressive strength reached 30-35 MPa. The highest 28-day compressive strength comes from 1.2 % Superplasticizer with 5 % fly ash proportion samples with the strength by 33 MPa. The sample with proportion of 1 % Superplasticizer and 7.5 % fly ash has the highest shrinkage value compared to other proportions. The characteristic of OPS as coarse aggregates is in a standard range of natural coarse aggregates. In general, this lightweight concrete using OPS coarse aggregate and Superplasticizer has high potential to be green-structural lightweight concrete alternative in Indonesia.Keywords: lightweight concrete, oil palm shell, waste materials, superplasticizer
Procedia PDF Downloads 2591471 Persistent Organic Pollutant Level in Challawa River Basin of Kano State, Nigeria
Authors: Abdulkadir Sarauta
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Almost every type of industrial process involves the release of trace quantity of toxic organic and inorganic compound that up in receiving water bodies, this study was aimed at assessing the Persistent Organic Pollutant Level in Challawa River Basin of Kano State, Nigeria. And the research formed the basis of identifying the presence of PCBs and PAHs in receiving water bodies in the study area, assessing the PCBs and PAHs concentration in receiving water body of Challawa system, evaluate the concentration level of PCBs and PAHs in fishes in the study area, determine the concentration level of PCBs and PAHs in crops irrigated in the study area as well as compare the concentration of PCBs and PAHs with the acceptable limit set by Nigerian, EU, U.S and WHO standard. Data were collected using reconnaissance survey, site inspection, field survey, laboratory experiment as well as secondary data source. A total of 78 samples were collected through stratified systematic random sampling (i.e., 26 samples for each of water, crops and fish) three sampling points were chosen and designated A, B and C along the stretch of the river (i.e. up, middle, and downstream) from Yan Danko Bridge to Tambirawa bridge. The result shows that the Polychlorinated biphenyls (PCBs) was not detected while, polycyclic aromatic hydrocarbons (PAHs) was detected in the whole samples analysed at the trench of Challawa River basin in order to assess the contribution of human activities to global environmental pollution. The total concentrations of ΣPAH and ΣPCB ranges between 0.001 to 0.087mg/l and 0.00 to 0.00mg/l of water samples While, crops samples ranges between 2.0ppb to 8.1ppb and fish samples ranges from 2.0 to 6.7ppb.The whole samples are polluted because most of the parameters analyzed exceed the threshold limits set by WHO, Nigerian, U.S and EU standard. The analytical results revealed that some chemicals are present in water, crops and fishes are significantly very high at Zamawa village which is very close to Challawa industrial estate and also is main effluent discharge point and drinking water around study area is not potable for consumption. Analysis of Variance was obtained by Bartlett’s test performance. There is only significant difference in water because the P < 0.05 level of significant, But there is no difference in crops concentration they have the same performance, likes wise in the fishes. It is said to be of concern to health hazard which will increase incidence of tumor related diseases such as skin, lungs, bladder, gastrointestinal cancer, this show there is high failure of pollution abatement measures in the area. In conclusion, it can be said that industrial activities and effluent has impact on Challawa River basin and its environs especially those that are living in the immediate surroundings. Arising from the findings of this research some recommendations were made the industries should treat their liquid properly by installing modern treatment plants.Keywords: Challawa River Basin, organic, persistent, pollutant
Procedia PDF Downloads 5751470 Alpha-To-Omega Phase Transition in Bulk Nanostructured Ti and (α+β) Ti Alloys
Authors: Askar Kilmametov, Julia Ivanisenko, Boris Straumal, Horst Hahn
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The high-pressure α- to ω-phase transition was discovered in elemental Ti and Zr fifty years ago using static high pressure and then observed to appear between 2 and 12 GPa at room temperature, depending on the experimental technique, the pressure environment, and the sample purity. The fact that ω-phase is retained in a metastable state in ambient condition after the removal of the pressure has been used to check the changes in magnetic and superconductive behavior, electron band structure and mechanical properties. However, the fundamental knowledge on a combination of both mechanical treatment and high applied pressure treatments for ω-phase formation in Ti alloys is currently lacking and has to be studied in relation to improved mechanical properties of bulk nanostructured states. In the present study, nanostructured (α+β) Ti alloys containing β-stabilizing elements such as Co, Fe, Cr, Nb were performed by severe plastic deformation, namely high pressure torsion (HPT) technique. HPT-induced α- to ω-phase transformation was revealed in dependence on applied pressure and shear strains by means of X-ray diffraction, transmission electron microscopy, and differential scanning calorimetry. The transformation kinetics was compared with the kinetics of pressure-induced transition. Orientation relationship between α-, β- and ω-phases was taken into consideration and analyzed according to theoretical calculation proposed earlier. The influence of initial state before HPT appeared to be considerable for subsequent α- to ω-phase transition. Thermal stability of the HPT-induced ω-phase was discussed as well in the frame of mechanical behavior of Ti and Ti-based alloys produced by shear deformation under high applied pressure.Keywords: bulk nanostructured materials, high pressure phase transitions, severe plastic deformation, titanium alloys
Procedia PDF Downloads 4191469 Spatial Analysis the Suitability Area for Jatropha curcas L. as an Alternative to Biodiesel in Central Kalimantan, Indonesia
Authors: Rizki Oktariza, Sri Fauza Pratiwi, Hilza Ikhsanti
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Human depends on fossil fuels as the bigger sources of considerable energy in all sectors. Based on that cases, we are needed alternative energy to supplies needed for fuel, one of them by using energy fuel from the biodiesel. The raw materials that can be used for producing the biodiesel energy are Jatropha curcas L. In Indonesia, the availability of land for the development of the Jatropha curcas L which has very appropriate Indonesia reached 14.2 million hectares, with an area of suitable in Kalimantan around 10 million hectares. In Central Kalimantan, as one of the provinces of Kalimantan, has considerable potential planting Jatropha curcas L because of the physical condition and have a largest of the agricultural land. To support the potential of Jatropha curcas L in Central Kalimantan, spatial analysis is needed to find out the appropriate areas for Jatropha curcas L growing land. The suitability of region is influenced by several variables i.e., rainfall, the slope of the land, the surface temperature and the altitude of a region. The compliance of criteria are divided into four criteria: high suitable (S1), moderately suitable (S2), marginally suitable (S3), not suitable (N). The suitability of the region is based on these variables and made an overlay analysis of these variables by using Geographic Information System. Based on this overlay analysis will results a map of the suitability area for planting Jatropha curcas L, which is distribution criteria is high suitable (S1) of 213,245 ha, moderately suitable (S2) of 14,389,353 ha, marginally suitable (S3) 360,357 ha, not suitable (N) 0.020 ha.Keywords: geographic information system, Jatropha curcas L., overlay, the suitable area
Procedia PDF Downloads 1761468 Inducing Flow Experience in Mobile Learning: An Experiment Using a Spanish Learning Mobile Application
Authors: S. Jonsson, D. Millard, C. Bokhove
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Smartphones are ubiquitous and frequently used as learning tools, which makes the design of educational apps an important area of research. A key issue is designing apps to encourage engagement while maintaining a focus on the educational aspects of the app. Flow experience is a promising method for addressing this issue, which refers to a mental state of cognitive absorption and positive emotion. Flow experience has been shown to be associated with positive emotion and increased learning performance. Studies have shown that immediate feedback is an antecedent to Flow. This experiment investigates the effect of immediate feedback on Flow experience. An app teaching Spanish phrases was developed, and 30 participants completed both a 10min session with immediate feedback and a 10min session with delayed feedback. The app contained a task where the user assembles Spanish phrases by pressing bricks with Spanish words. Immediate feedback was implemented by incorrect bricks recoiling, while correct brick moved to form part of the finished phrase. In the delayed feedback condition, the user did not know if the bricks they pressed were correct until the phrase was complete. The level of Flow experienced by the participants was measured after each session using the Flow Short Scale. The results showed that higher levels of Flow were experienced in the immediate feedback session. It was also found that 14 of the participants indicated that the demands of the task were ‘just right’ in the immediate feedback session, while only one did in the delayed feedback session. These results have implications for how to design educational technology and opens up questions for how Flow experience can be used to increase performance and engagement.Keywords: feedback timing, flow experience, L2 language learning, mobile learning
Procedia PDF Downloads 1331467 Investigating The Effect Of Convection On The Rating Of Buried Cables Using The Finite Element Method
Authors: Sandy J. M. Balla, Jerry J. Walker, Isaac K. Kyere
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The heat transfer coefficient at the soil–air interface is important in calculating underground cable ampacity when convection occurs. Calculating the heat transfer coefficient accurately is complex because of the temperature variations at the earth's surface. This paper presents the effect of convection heat flow across the ground surface on the rating of three single-core, 132kV, XLPE cables buried underground. The Finite element method (FEM) is a numerical analysis technique used to determine the cable rating of buried cables under installation conditions that are difficult to support when using the analytical method. This study demonstrates the use of FEM to investigate the effect of convection on the rating ofburied cables in flat formation using QuickField finite element simulation software. As a result, developing a model to simulate this type of situation necessitates important considerations such as the following boundary conditions: burial depth, soil thermal resistivity, and soil temperature, which play an important role in the simulation's accuracy and reliability. The results show that when the ground surface is taken as a convection interface, the conductor temperature rises and may exceed the maximum permissible temperature when rated current flows. This is because the ground surface acts as a convection interface between the soil and the air (fluid). This result correlates and is compared with the rating obtained using the IEC60287 analytical method, which is based on the condition that the ground surface is an isotherm.Keywords: finite element method, convection, buried cables, steady-state rating
Procedia PDF Downloads 1311466 A Comparative Study for Various Techniques Using WEKA for Red Blood Cells Classification
Authors: Jameela Ali, Hamid A. Jalab, Loay E. George, Abdul Rahim Ahmad, Azizah Suliman, Karim Al-Jashamy
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Red blood cells (RBC) are the most common types of blood cells and are the most intensively studied in cell biology. The lack of RBCs is a condition in which the amount of hemoglobin level is lower than normal and is referred to as “anemia”. Abnormalities in RBCs will affect the exchange of oxygen. This paper presents a comparative study for various techniques for classifyig the red blood cells as normal, or abnormal (anemic) using WEKA. WEKA is an open source consists of different machine learning algorithms for data mining applications. The algorithm tested are Radial Basis Function neural network, Support vector machine, and K-Nearest Neighbors algorithm. Two sets of combined features were utilized for classification of blood cells images. The first set, exclusively consist of geometrical features, was used to identify whether the tested blood cell has a spherical shape or non-spherical cells. While the second set, consist mainly of textural features was used to recognize the types of the spherical cells. We have provided an evaluation based on applying these classification methods to our RBCs image dataset which were obtained from Serdang Hospital-Malaysia, and measuring the accuracy of test results. The best achieved classification rates are 97%, 98%, and 79% for Support vector machines, Radial Basis Function neural network, and K-Nearest Neighbors algorithm respectivelyKeywords: red blood cells, classification, radial basis function neural networks, suport vector machine, k-nearest neighbors algorithm
Procedia PDF Downloads 4801465 Water Quality and Coastal Management Profile Assessment of Puerto Galera Bay, Philippines
Authors: Ma. Manna Farrel B. Pinto
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As global industrialization progresses, the environment remains to be at risk of disturbances brought by developments of cities and communities. Impacts of flourishing industries such as tourism require rapid growth of establishments and may threaten ecosystems and natural resources. Puerto Galera as a biosphere reserve and declared as the Center of the World’s Center of Marine Shorefish Biodiversity is on the brink of ecological deterioration as tourism further develops in its coastal areas. Apparently, attempts were initiated to establish a baseline for designation of protection in the economic and coastal marine zones of Puerto Galera but continuity of its implementation and coordination of concerned units remains deficient. Indications of eutrophication have been observed based on water quality analysis although parameter values still comply with the national standards for coastal waters. Water quality data, biodiversity and hydrodynamic information, gathered from studies, and local government units were analysed to assess the condition of the coast as well as acting policies implemented by the local authorities. Sources of contaminants were also located in its three main communities, and their shores wherein in recommendations for installing wastewater treatment facilities and further improvement of policies of waste discharge must be addressed. With a conceptual framework proposed in the study, a comprehensive data analysis and coordinated management are necessary to form an integrated coastal management for further protection and preservation of the sustainable coastal marine ecosystem of Puerto Galera.Keywords: coastal management, environmental management, integrated resource management, Puerto Galera
Procedia PDF Downloads 2671464 Distributed Cost-Based Scheduling in Cloud Computing Environment
Authors: Rupali, Anil Kumar Jaiswal
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Cloud computing can be defined as one of the prominent technologies that lets a user change, configure and access the services online. it can be said that this is a prototype of computing that helps in saving cost and time of a user practically the use of cloud computing can be found in various fields like education, health, banking etc. Cloud computing is an internet dependent technology thus it is the major responsibility of Cloud Service Providers(CSPs) to care of data stored by user at data centers. Scheduling in cloud computing environment plays a vital role as to achieve maximum utilization and user satisfaction cloud providers need to schedule resources effectively. Job scheduling for cloud computing is analyzed in the following work. To complete, recreate the task calculation, and conveyed scheduling methods CloudSim3.0.3 is utilized. This research work discusses the job scheduling for circulated processing condition also by exploring on this issue we find it works with minimum time and less cost. In this work two load balancing techniques have been employed: ‘Throttled stack adjustment policy’ and ‘Active VM load balancing policy’ with two brokerage services ‘Advanced Response Time’ and ‘Reconfigure Dynamically’ to evaluate the VM_Cost, DC_Cost, Response Time, and Data Processing Time. The proposed techniques are compared with Round Robin scheduling policy.Keywords: physical machines, virtual machines, support for repetition, self-healing, highly scalable programming model
Procedia PDF Downloads 1681463 Restored CO₂ from Flue Gas and Utilization by Converting to Methanol by 3 Step Processes: Steam Reforming, Reverse Water Gas Shift and Hydrogenation
Authors: Rujira Jitrwung, Kuntima Krekkeitsakul, Weerawat Patthaveekongka, Chiraphat Kumpidet, Jarukit Tepkeaw, Krissana Jaikengdee, Anantachai Wannajampa
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Flue gas discharging from coal fired or gas combustion power plant contains around 12% Carbon dioxide (CO₂), 6% Oxygen (O₂), and 82% Nitrogen (N₂).CO₂ is a greenhouse gas which has been concerned to the global warming. Carbon Capture, Utilization, and Storage (CCUS) is a topic which is a tool to deal with this CO₂ realization. Flue gas is drawn down from the chimney and filtered, then it is compressed to build up the pressure until 8 bar. This compressed flue gas is sent to three stages Pressure Swing Adsorption (PSA), which is filled with activated carbon. Experiments were showed the optimum adsorption pressure at 7bar, which CO₂ can be adsorbed step by step in 1st, 2nd, and 3rd stage, obtaining CO₂ concentration 29.8, 66.4, and 96.7 %, respectively. The mixed gas concentration from the last step is composed of 96.7% CO₂,2.7% N₂, and 0.6%O₂. This mixed CO₂product gas obtained from 3 stages PSA contained high concentration CO₂, which is ready to use for methanol synthesis. The mixed CO₂ was experimented in 5 Liter/Day of methanol synthesis reactor skid by 3 step processes as followed steam reforming, reverse water gas shift, and then hydrogenation. The result showed that proportional of mixed CO₂ and CH₄ 70/30, 50/50, 30/70 % (v/v), and 10/90 yielded methanol 2.4, 4.3, 5.6, and 6.0 Liter/day and save CO₂ 40, 30, 20, and 5 % respectively. The optimum condition resulted both methanol yield and CO₂ consumption using CO₂/CH₄ ratio 43/57 % (v/v), which yielded 4.8 Liter/day methanol and save CO₂ 27% comparing with traditional methanol production from methane steam reforming (5 Liter/day)and absent CO₂ consumption.Keywords: carbon capture utilization and storage, pressure swing adsorption, reforming, reverse water gas shift, methanol
Procedia PDF Downloads 1871462 Disassociating Preferences from Evaluations Towards Pseudo Drink Brands
Authors: Micah Amd
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Preferences towards unfamiliar drink brands can be predictably influenced following correlations of subliminally-presented brands (CS) with positively valenced attributes (US). Alternatively, evaluations towards subliminally-presented CS may be more variable, suggesting that CS-evoked evaluations may disassociate from CS-associated preferences following subliminal CS-US conditioning. We assessed this hypothesis over three experiments (Ex1, Ex2, Ex3). Across each experiment, participants first provided preferences and evaluations towards meaningless trigrams (CS) as a baseline, followed by conditioning and a final round of preference and evaluation measurements. During conditioning, four pairs of subliminal and supraliminal/visible CS were respectively correlated with four US categories varying along aggregate valence (e.g., 100% positive, 80% positive, 40% positive, 0% positive – for Ex1 and Ex2). Across Ex1 and Ex2, presentation durations for subliminal CS were 34 and 17 milliseconds, respectively. Across Ex3, aggregate valences of the four US categories were altered (75% positive, 55% positive, 45% positive, 25% positive). Valence across US categories was manipulated to address a supplemental query of whether US-to-CS valence transfer was summative or integrative. During analysis, we computed two sets of difference scores reflecting pre-post preference and evaluation performances, respectively. These were subjected to Bayes tests. Across all experiments, results illustrated US-to-CS valence transfer was most likely to shift evaluations for visible CS, but least likely to shift evaluations for subliminal CS. Alternatively, preferences were likely to shift following correlations with single-valence categories (e.g., 100% positive, 100% negative) across both visible and subliminal CS. Our results suggest that CS preferences can be influenced through subliminal conditioning even as CS evaluations remain unchanged, supporting our central hypothesis. As for whether transfer effects are summative/integrative, our results were more mixed; a comparison of relative likelihoods revealed that preferences are more likely to reflect summative effects whereas evaluations reflect integration, independent of visibility condition.Keywords: subliminal conditioning, evaluations, preferences, valence transfer
Procedia PDF Downloads 1541461 Embolization of Spinal Dural Arteriovenous Fistulae: Clinical Outcomes and Long-Term Follow-Up: A Multicenter Study
Authors: Walid Abouzeid, Mohamed Shadad, Mostafa Farid, Magdy El Hawary
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The most frequent treatable vascular abnormality of the spinal canal is spinal dural arteriovenous fistulae (SDAVFs), which cause progressive para- or quadriplegia mostly affecting elderly males. SDAVFs are present in the thoracolumbar region. The main goal of treatment must be to obliterate the shunting zone via superselective embolization with the usage of a liquid embolic agent. This study aims to evaluate endovascular technique as a safe and efficient approach for the treatment SDAVFs, especially with long-term follow-up clinical outcomes. Study Design: A retrospective clinical case study. From May 2010 to May 2017, 15 patients who had symptoms attributed to SDAVFs underwent the operation in the Departments of Neurosurgery in Suhag, Tanta, and Al-Azhar Universities and Interventional Radiology, Ain Shams University. All the patients had varying degrees of progressive spastic paraparesis with and without sphincteric disturbances. Endovascular embolization was used in all cases. Fourteen were males, with ages ranging from 45 to 74 years old. After the treatment, good outcome was found in five patients (33.3%), a moderate outcome was delineated in six patients (40 %), and four patients revealed a poor outcome (26.7%). Spinal AVF could be treated safely and effectively by the endovascular approach. Generally, there is no correlation between the disappearance of MRI abnormalities and significant clinical improvement. The preclinical state of the patient is directly proportional to the clinical outcome. Due to unexpected responses, embolization should be attempted even the patient is in a bad clinical condition.Keywords: spine, arteriovenous, fistula, endovascular, embolization
Procedia PDF Downloads 1081460 Theatrical Architecture in Bologna at the Beginning of the Twentieth Century: The Renaissance of Modernissimo Cinema
Authors: Giorgia Predari, Riccardo Gulli
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The paper describes the history and the stylistic choices adopted in the construction of Palazzo Ronzani in Bologna, which was the first building to rise after the heavy demolitions carried out in the historical center of the city at the beginning of the twentieth century. In 1910, the local administration adopted a detailed plan to change the aspect of the city, as it was already happening in the main European capitals. In this context, starting from 1911, the architect and scenographer Gualtiero Pontoni designed for Alessandro Ronzani -the owner of a well-known Bolognese beer company- his Palazzo, which is listed among the first multifunctional buildings in Bologna, containing offices, commercial activities, and entertainment spaces. In an area of about 2000 m², the architect was able to propose a theatre with a capacity of 2000 seats at the basement, shops, a cafè-chantant and a restaurant on the ground floor, clubs, studios and commercial stores on the mezzanine and the first plan, and a hotel on the upper floors. The whole core of the building, at the underground levels, consisted of a reinforced concrete frame (one of the first examples of this type of construction in the city), which allowed the hall to have a free span of 11 x 12 meters, and a height of about 9 meters. Used until 2007 as a cinema, the hall has remained then in disuse for almost 10 years, but now an important functional restoration project with a strong architectural and scenographic value is taking place. It will bring the spaces back to the original geometries, in a historical and artistic condition inspired by the styles of the early Twentieth century.Keywords: Modernissimo, Palazzo Ronzani, liberty, Bologna
Procedia PDF Downloads 1211459 Drying Kinetics of Okara (Soy Pulp) Using the Multi-Commodity Heat Pump Dryer (MCHPD)
Authors: Lorcelie B. Taclan, Jolly S. Balila, Maribel Balagtas, Eunice M. Aclan, Myrtle C. Orbon, Emson Y. Taclan, Irenea A. Centeno
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Okara (soy pulp), a by-product and waste from the production of soymilk, tufo and tokwa and soybean-based vegan food products is readily available in the university thrice a week. The Food Factory owned and managed by AUP produces these food products weekly. Generally the study was conducted to determine the drying kinetics of soya pulp using the MCHPD. Specifically, it aimed to establish the time of drying; moisture loss per hour and percent moisture content of soya pulp and to establish the dried okara as an ingredient to other foods. The MCHPD is drying equipment that has an ideal drying condition of 50.00C and 10.0% relative humidity. Fresh and wet soya pulp were weighed at 1.0 kg per tray (21 drying trays), laid on the trays lined with cheese cloth. The MCHPD was set to desired drying conditions. Weight loss was monitored every hour and calculated using standard formulas. Research results indicated that the drying time for soya pulp was 19.0 hours; the % moisture content was reduced from 87.6.0% to 9.7.0% at an average moisture loss of 3.0 g/hr. The nutritional values of okara were favorably maintained with enhanced color. The dried okara was added as an ingredient to other healthy bakery products produced by the AUP Food Factory. Making use of okara would add nutritional values to other food products and would also help waste management concerns inside the university.Keywords: okara, MCHPD, drying kinetics, nutritional values, waste management
Procedia PDF Downloads 3961458 The Role of Strategic Alliances, Innovation Capability, Cost Reduction in Enhancing Customer Loyalty and Firm’s Competitive Advantage
Authors: Soebowo Musa
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Mining industries are known to be very volatile due to their sensitive nature toward changes in the environment, particularly coal mining. Heavy equipment distributors and coal mining contractors are among heavily affected by such volatility. They are facing more uncertainty on the sustainability of the coal mining industry. Strategic alliances and organizational capabilities such as innovation capability have long been seen as ways to stay competitive with a focus more on the strategic alliances partner-to-partner in serving their customers. In today’s rapid change in the environment, a shift in consumer behaviors, and the human-centric business approach, this study looks at the strategic alliance partner-to-customer relationship in both the industrial organization and resource-based theories. This study was conducted based on 250 respondents from the strategic alliances partner-to-customer between heavy equipment distributors and coal mining contractors in Indonesia. This study finds strategic alliances have the highest association toward cost reduction, a proxy of operational efficiency followed by its association toward innovation capability. Further, strategic alliances and innovation capability have a positive relationship with customer loyalty, while innovation capability and customer loyalty have no significant relationships toward the firm’s competitive advantage. This study also indicates that cost reduction is not a condition to develop customer loyalty in the strategic alliance partner-to-customer relationship. It confirms strategic alliances are a strategy that creates a firm’s operational efficiency, innovation capability that develops customer loyalty, and competitive advantage.Keywords: strategic alliance, innovation capability, cost reduction, customer loyalty, competitive advantage
Procedia PDF Downloads 1191457 Retrofitting Residential Buildings for Energy Efficiency: An Experimental Investigation
Authors: Naseer M. A.
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Buildings are major consumers of energy in both their construction and operation. They account for 40% of World’s energy use. It is estimated that 40-60% of this goes for conditioning the indoor environment. In India, like many other countries, the residential buildings have a major share (more than 50%) in the building sector. Of these, single-family units take a mammoth share. The single-family dwelling units in the urban and fringe areas are built in two stories to minimize the building foot print on small land parcels. And quite often, the bedrooms are located in the first floors. The modern buildings are provided with reinforced concrete (RC) roofs that absorb heat throughout the day and radiate the heat into the interiors during the night. The rooms that are occupied in the night, like bedrooms, are having their indoors uncomfortable. This has resulted in the use of active systems like air-conditioners and air coolers, thereby increasing the energy use. An investigation conducted by monitoring the thermal comfort condition in the residential building with RC roofs have proved that the indoors are really uncomfortable in the night hours. A sustainable solution to improve the thermal performance of the RC roofs was developed by an experimental study by continuously monitoring the thermal comfort parameters during summer (the period that is most uncomfortable in temperate climate). The study conducted in the southern peninsular India, prove that retrofitting of existing residential building can give a sustainable solution in abating the ever increasing energy demand especially when it is a fact that these residential buildings that are built for a normal life span of 40 years would continue to consume the energy for the rest of its useful life.Keywords: energy efficiency, thermal comfort, retrofitting, residential buildings
Procedia PDF Downloads 2521456 Mycophenolate-Induced Disseminated TB in a PPD-Negative Patient
Authors: Megan L. Srinivas
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Individuals with underlying rheumatologic diseases such as dermatomyositis may not adequately respond to tuberculin (PPD) skin tests, creating false negative results. These illnesses are frequently treated with immunosuppressive therapy making proper identification of TB infection imperative. A 59-year-old Filipino man was diagnosed with dermatomyositis on the basis of rash, electromyography, and muscle biopsy. He was initially treated with IVIG infusions and transitioned to oral prednisone and mycophenolate. The patient’s symptoms improved on this regimen. Six months after starting mycophenolate, the patient began having fevers, night sweats, and productive cough without hemoptysis. He moved from the Philippines 5 years prior to dermatomyositis diagnosis, denied sick contacts, and was PPD negative both at immigration and immediately prior to starting mycophenolate treatment. A third PPD was negative following the onset of these new symptoms. He was treated for community-acquired pneumonia, but symptoms worsened over 10 days and he developed watery diarrhea and a growing non-tender, non-mobile mass on the left side of his neck. A chest x-ray demonstrated a cavitary lesion in right upper lobe suspicious for TB that had not been present one month earlier. Chest CT corroborated this finding also exhibiting necrotic hilar and paratracheal lymphadenopathy. Neck CT demonstrated the left-sided mass as cervical chain lymphadenopathy. Expectorated sputum and stool samples contained acid-fast bacilli (AFB), cultures showing TB bacteria. Fine-needle biopsy of the neck mass (scrofula) also exhibited AFB. An MRI brain showed nodular enhancement suspected to be a tuberculoma. Mycophenolate was discontinued and dermatomyositis treatment was switched to oral prednisone with a 3-day course of IVIG. The patient’s infection showed sensitivity to standard RIPE (rifampin, isoniazid, pyrazinamide, and ethambutol) treatment. Within a week of starting RIPE, the patient’s diarrhea subsided, scrofula diminished, and symptoms significantly improved. By the end of treatment week 3, the patient’s sputum no longer contained AFB; he was removed from isolation, and was discharged to continue RIPE at home. He was discharged on oral prednisone, which effectively addressed his dermatomyositis. This case illustrates the unreliability of PPD tests in patients with long-term inflammatory diseases such as dermatomyositis. Other immunosuppressive therapies (adalimumab, etanercept, and infliximab) have been affiliated with conversion of latent TB to disseminated TB. Mycophenolate is another immunosuppressive agent with similar mechanistic properties. Thus, it is imperative that patients with long-term inflammatory diseases and high-risk TB factors initiating immunosuppressive therapy receive a TB blood test (such as a quantiferon gold assay) prior to the initiation of therapy to ensure that latent TB is unmasked before it can evolve into a disseminated form of the disease.Keywords: dermatomyositis, immunosuppressant medications, mycophenolate, disseminated tuberculosis
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